National Healthcare Quality Week, observed on October 15 to 21, celebrates the many healthcare quality professionals who tirelessly work toward ensuring that quality service is delivered. This week is also a time to spread awareness of the importance of quality healthcare services and create policies that facilitate the safety of both patients and healthcare professionals.

In honor of National Healthcare Quality Week, we’re spotlighting Magellan Health’s Allie Kelley, quality specialist. Some of Kelley’s responsibilities to ensure quality healthcare include managing certain member notifications, generating internal reports for customer requirements, and assisting with EAP record requests within our Employee Assistance Program (EAP) provider network. Continue reading to learn more about Kelley’s work in healthcare quality:

What sort of projects are you currently working on?

I am brand new to the responsibility of running a Quality Improvement Activity (QIA) so I’m learning responsibilities such as barrier analysis, which examines limitations or obstacles to the efficiency of a process or desired outcome, investigating root causes, developing, and discussing interventions, and ongoing monitoring are my biggest tasks right now.  I am very excited about how this process can improve the level of service we provide to our members. It is awesome to have different department leaders come together to talk about barriers and interventions to improve identified metrics and then be able to measure the success of these interventions.

Why is Magellan Health the best place to do this project?

Magellan’s values include integrity, accountability, knowledge, collaboration, caring, creativity, and results. Every one of those values is critical to the success of any QIA. Leadership also shows great support of the overall QI department, and ultimately Magellan as a whole.

What are your thoughts on the culture here at Magellan?

I have been a part of Magellan Health for 25 years and have had the opportunity to work in many different roles. I have seen this company grow in the healthcare industry, and I have never once doubted how much Magellan cares for and believes in their employees. Magellan has been an industry leader when it comes to diversity, equity, and inclusion, and offering comprehensive employee benefits.

Beyond that, the member lives we cover, especially the most vulnerable populations, have always been the most important thing to me in every position I’ve held here. Magellan’s philosophy and mission have always aligned with this. Positively influencing the health and wellbeing of our members has always been a top priority throughout this organization.

How did you get involved with the Healthcare Quality field?

My heart and my passion have always been with our members and working to make sure they are receiving the best care possible. I am a social worker at heart, so when I read the job description for my current role, it was very clear to me that the role in a strong Quality Department is not at all separate from what my mission in the clinical department had always been! I became excited about the possibility of stepping out of my comfort zone while keeping in mind what I came here to do, which is to help people.

What are some of the most challenging and rewarding aspects of working in Healthcare Quality?

Some of the more challenging aspects have been learning the more technical side of things, while the most rewarding part of being in this department has been being a part of a team so committed to integrity, accountability, and data driven results. This is demonstrated in the preparation of the annual Trilogy documents, where everyone on the team comes together to work toward a common objective. Trilogy is our annual evaluation of the QI Program that evaluates outcomes, reviews effectiveness, assesses goal achievements, evaluates the deployment of resources, documents, and trends input from advisory groups. Seeing that final document come together was amazing. I was so proud to have contributed to that and we are getting ready to do it all over!

What does Healthcare Quality Week mean to you? Is there anything else you’d like to highlight about Healthcare Quality?

Healthcare Quality Week to me is a time to raise awareness of the positive impact healthcare quality professionals have in our organizations and communities. At Magellan Health, healthcare quality is organized around the positive influence of the health and wellbeing of individuals by identifying gaps in care and service, improving clinical outcomes, assuring patient safety, and adding value through efficiency. In healthcare quality we’re also focused on enhancing services and the individual’s experience of care. We also work to assure that all core business processes are innovative and meet or exceed contract, regulatory, and accreditation guidance while leading to system and cost efficiencies.

The first full week in October, organizations are taking the time to recognize and celebrate their employees in customer service. Customer Service Week is an international celebration that highlights the importance of customer service and those individuals who serve and support customers daily. We’re spotlighting four Magellan Health employees who share why they chose to work in customer service, and some of their most rewarding and challenging aspects of working in this field:

• America Phinsee, care worker
• Kimberly White, outreach and engagement specialist
• Edward Daduya, supervisor, customer care
• Chelsey Aguilar, customer experience associate

Continue reading to learn more from America, Kimberly, Edward, and Chelsey on their experiences working in customer service:

Why did you want to pursue customer service and what is the most rewarding aspect of working in this field?

America: I pursued a career in customer service because I have a genuine desire to help others in a way that directly impacts their personal or professional life in a positive way. The most rewarding aspect of working in this field is going above and beyond for our members and being able to hear the joy in their voice when you deliver good news to them.

Kimberly: Customer service chose me. I have always been in a role of wanting to help people find resolutions, that is the most rewarding outcome. Being that person who gets someone the help they need and hearing the satisfaction on the other end is very rewarding.

Edward: I decided to embark on a career in customer service because of my passion for assisting individuals and resolving their concerns. The most gratifying aspect of this profession is being given the chance to make a positive change in our customers’ lives. It’s truly fulfilling to recognize that I have the capacity to aid customers in addressing their challenges and leave them with a favorable perception of our company.

Chelsey: I personally pursued customer service because I genuinely enjoy problem solving and providing service that can initially resolve issues or concerns for people seeking answers. It is crucial to understand the importance of customer service because delivery of customer service can have a major impact in someone’s life.

What are some challenges you face in this profession and how do you overcome them?

America: My biggest challenge in customer service is not knowing the answer to a question, sometimes agents are caught off guard and simply can’t answer a complex question. However, the best way to overcome this challenge is to put yourself in the member’s shoes. Ask yourself what information you would need if you were the member; then you will be able to anticipate the questions, you will find the answers, and be ready when the questions arise.

Kimberly: As much as I would like to say that every call is a success, it’s not. Sometimes it’s hard to connect with people. Some people just want to vent and are not going to be happy with me, my company, their health plan, or even themselves. In those situations, it’s my responsibility to not take it personally, to listen more than I speak, be empathetic, ask questions, and try to do everything I can to get some sort of resolution on the call. At the very minimum set up a tone so when we do talk to them again, it might be a better experience for them.

Edward: The realm of customer service often presents challenges stemming from diverse factors, including managing clients, addressing intricate problems, and striving to meet elevated service standards. To surmount these obstacles, I place an emphasis on active listening, empathy, and proficient communication. Furthermore, I maintain an ongoing commitment to training and supporting my team, ensuring they possess the requisite skills to adeptly navigate these complexities.

Chelsey: The biggest challenge that I face in this profession would be incoming calls that relate to customer grievances. It’s important to listen to the caller, learn from the mistakes, and if possible, resolve the caller’s concerns. Callers need to be reassured that they are valued, and their time is important. We can build trusting relationships with our callers by initiating a safe space for callers to voice their concern and then proactively taking the steps to get a resolution for the caller.

Is there anything you’d like to highlight about working in customer service?

America: I believe that what we do is very important. We assist our members, and their loved ones to find adequate mental health. Some calls with members are better than others, but we must always show empathy and compassion. It helps to remember that our members are looking to us for assistance and when we deliver the help, our members can get their life back on track.

Kimberly: It’s not always the easiest but there is always satisfaction in helping others. I always try to remember the phrase about how important listening is, “How can we help people if we do not listen to the problem first?”

Edward: Customer service extends beyond addressing customer issues; it involves cultivating enduring relationships. It offers a platform to embody our company’s principles and showcase our unwavering dedication to customer contentment. This dynamic domain presents a diverse array of experiences, where each day brings new challenges and continuous opportunities for learning.

Chelsey: Essentially working in this field can help you become a more mindful person because customer service can help shape individuals to be more aware of their approach and delivery to others’ concerns.

What does Customer Service Week mean to you?

America: Customer Service Week means this is the time in which we recognize, appreciate, and celebrate those on the front line, for without them, there would be no human connection over the phone.

Kimberly: It means a time for me to be happy and reflect on the impact I make within my organization and be recognized for it.

Edward: Customer Service Week holds a special significance for me as it serves as a dedicated occasion to honor and commemorate the steadfast commitment and diligent efforts of our customer care team. It acts as a powerful reminder, emphasizing the importance of the customer experience in our organization and aligning seamlessly with our foundational company values. This week is a time of reflection, celebration, and renewed commitment. It serves as a testament to our dedication to customer satisfaction, embodying our company’s values at every step of the way.

Chelsey: Customer Service Week is a time to appreciate all of those who provide services to others. Whether it’s a phone call to your insurance rep, the grocery store clerk, or the person behind the check-in desk, take the time to thank those who help you!

Throughout March we’re celebrating National Social Worker Month by recognizing the over 600,000 social workers throughout the country who work tirelessly to solve social issues and improve the lives of individuals. Social workers spend every day improving the quality of someone’s life and continuing to advocate for their patients, which can be emotionally draining work that can often lead to burnout. We’re spotlighting three of Magellan Health’s social workers who each explain why they became social workers, and what is the most rewarding and challenging aspects of working in this field:

• Tara Karbiner, director of clinical services, has been with Magellan for 23 years.

• Margarita Dewalt, LSW, Community HealthChoices care manager, started at Magellan late last year.

• Trisha Dryzga, manager, clinical services, joined Magellan in 2016; has been in current role since 2020.

Continue reading to learn more from Tara, Margarita, and Trisha on their experiences as social workers:

Why did you become a social worker and what is the most rewarding aspect of working in this field? 

Tara: I always wanted to assist people when they were most at need and vulnerable.  I have always enjoyed helping people identify what their needs are and then trying to connect them to the right supports and services to meet those needs.  Making a difference in someone’s life can range from helping provide concrete services to just establishing a supportive relationship with them.    The most rewarding aspect is supporting a person in reaching one of their goals and seeing the impact that has on their life.

Margarita: I became a social worker because I wanted to make a difference or a change in someone’s life for the better. I wanted to be a resource or helping hands for those in need. The most rewarding aspect of being a social worker is seeing the impact that you have, big or small. I also enjoy helping others overcome their mental health and social needs by providing them with coping skills or ability to problem solve to live better lives.

Trisha: I grew up interested in behavioral health. In college I majored in Psychology and minored in Sociology. I had a sociology professor who was an LCSW and had an interesting career path. He talked to me about the possibilities in the social work field which piqued my interest. I went straight to graduate school and obtained my MSW in 2004. I find the work to be challenging and rewarding at the same time. The occasional success stories on both the individual and systems levels make the work rewarding. For my current role I find the teamwork aspect to be very rewarding. I am lucky to work with very caring, compassionate people who believe in their work and who take time to support one another.

What are some challenges you face being a social worker and how do you overcome them? 

Tara: The biggest challenges are the gaps within the system of care to best support people- there are deficiencies across all systems and many people go without the basic supports to reach their potential.  I try to brainstorm, and problem solve multiple solutions to the same issue so that we can pursue many ways to get the needs met.  As a social worker you need to never give up but keep pushing the system and advocating for your members to ensure they have what they need to be successful.

Margarita: A challenges I face being a social worker is often the lack of resources for vulnerable people in need. I hope that we can change this by raising awareness and finding opportunities and resources for providers to be able to provide those additional services, supports or programs.

Trisha: There are many challenges in social work, including having enough resources to meet the needs of the individuals we serve, often hearing and seeing some very difficult cases and constantly advocating for additional resources for those in need. In terms of overcoming these challenges I maintain hope that we can build a better mental health system, with increased flow to allow for everyone to access the right level of care at the right time. On days when it’s hard to hold on to that hope – I practice some extra self-care – go for a walk, read, or spend time with family.

Is there anything you’d like to highlight about working in this field? 

Tara: Social workers are compassionate, creative, persistent, and problem solvers.  At times social workers must take on the burdens of the members they support to allow the member some relief from the daily pressures.

Margarita: Working in the social work field has always challenged me to think outside the box and seek opportunities that could really change an outcome for the better.

Trisha: I think the work we do is very important to our society overall; social workers have an array of roles throughout our communities that assist with treatment and accessing resources.

What does National Social Worker Month mean to you? 

Tara: It is validating to have a month that recognizes many of the unsung heroes working daily to support members.

Margarita: National Social Worker month means that I can be a part of something greater than myself and that itself is so rewarding.

Trisha: It means recognizing the hard work and challenges social workers face every day. It brings awareness to the profession and shows that it is valued in our society.

Kristen Ford, vice president of product innovation and development for behavioral health, has led many new innovative products being developed at Magellan Health. In her position, Ford is responsible for the product innovation and development activities for behavioral health solutions. Ford, who is based in Oregon, has worked for Magellan Health for 12 years on various innovation strategies focused on best-in-class services that help members live healthier lives. She is a Six Sigma Black Belt and a clinician who’s passionate about driving human-centered product development that changes lives. Most recently she’s helped to launch a full continuum population health wellbeing solution to improve population engagement into evidence-based care and improve the quality and accessibility of healthcare for those that are thriving, struggling or suffering. Continue reading to learn more about Ford’s work on these innovative products:

What cool, innovative products are you currently working on?

My responsibilities focus on new products that drive growth, leverage Magellan Health’s thought leadership, and enhance the lives of the people we serve. One example is the development of a comprehensive autism strategy where we are creating new mechanisms for timely access to autism screening with faster diagnosis to improve early intervention. We are laying the groundwork for new clinical models that intertwine technology, diagnostics, therapeutics and facilitate better coordinated care for the whole child.

We’re also working on other complex areas of healthcare such as suicide prevention. We care deeply about the recent increase in population suicide trends and our mission is to make suicide a never event. We do that through creating solutions that empower individuals with knowledge, education and tools in an environment of uninterrupted and supportive care.

Medical integration is another area of focus with our new collaborative care product which improves medical and behavioral health integration by making it easier for primary care physicians to diagnose and treat members’ behavioral health condition in the office. We’re looking at ways to solve important challenges in the delivery of behavioral healthcare by working on solutions that enable navigation, digital engagement, transform the delivery system and offer new models of care.

Can you expand on the work you’re doing with projects like Mightier, NeuroFlow and DUOS?

Mightier is a biofeedback gaming solution that teaches children emotional regulation to help them manage big emotions and teach calming strategies. This is important because it offers a bridge to care for children and families that are struggling. It’s been shown to be highly effective in randomized control trials for children with autism, ADHD, OCD or other similar conditions. It’s improved oppositional behaviors in children and decreased caregiver stress. We’re currently working with Mightier on a study through the National Institute of Mental Health to show that using this type of intervention can improve quality and cost of care.

We’re also working with NeuroFlow to deliver a collaborative care product, which expands Magellan’s value proposition with the ability to manage total cost of care. NeuroFlow brings the technology, and Magellan provides the clinical management which has resulted in a solution that is highly appreciated by our clients. We also launched the NeuroFlow population health app which provides digital wellbeing and self-care tools, including our digital cognitive behavioral therapy modules, to help members improve overall health and wellbeing, manage stress and build resilience in a confidential manner.

DUOS is an opportunity for us to address the social determinants of health and needs of older populations. DUOS provides a personal assistant for aging – a DUO – to help older adults stay healthy and age independently in their own homes. We connect older adults with social support and resources to manage social isolation, healthcare access and behavioral health needs. In our pilot results, we found that 97% of seniors were linked to resources to meet their needs and has high satisfaction with a net promoter score of 88.

Why is Magellan Health the best place to build new innovative products?

We are fortunate to have an executive leadership team that developed a culture that supports innovation. It’s part of our DNA. We have been successful in evolving our innovation strategy that positions Magellan as a thought leader and innovator in the behavioral health and wellbeing space. Our executive leadership believes that innovation is essential in treating the whole person, achieving growth and moving our business forward.

What are your thoughts on Magellan’s culture? How has that culture impacted the products you’ve worked on?

I think it’s a highly collaborative and team-oriented culture. Everyone is willing to roll up their sleeves and help achieve the best outcomes. The Magellan culture is purpose and mission driven. Everyone you encounter is focused on the best ways to support our customers, ensure members have the best experience and they’re getting the best care possible. I think that’s the picture of Magellan and it’s a wonderful place to work and drive innovation.

Currently, we have a pipeline of over 44 different products or product enhancements that we’d like to explore. People are familiar with Magellan’s culture of dedication and innovation. As a result, they are willing to collaborate and advise us as we drive towards solutions that can improve the lives of those members we serve.

What exciting trends in the healthcare industry have you noticed? What direction do you see healthcare going? What lessons are there to learn in other industries that can be applied to healthcare?

There are new trends in the field of autism related to clinical advancement and how we work with children on the spectrum as well as exciting developments and solutions in managing the total cost of care. There are new approaches that allow us to combine technology and clinical acumen deliver new care models. The pandemic created an environment where members and providers used new technologies and tools out of necessity which now provides us opportunity to continue to build and accelerate the adoption of new care models through technology. We are also seeing new and exciting opportunities to engage and activate members while reducing stigma.

Some industries can market directly and successfully engage the end user. We can learn from those industries and drive growth through that engagement.

We are fortunate that the Magellan leadership team and culture supports us in exploring those recent trends and solving for some of the most difficult challenges we see in service delivery.

Edith Calamia, DO, MPH, CMD, was a teenager when she saw the impact that lack of access to clean water, food insecurities, and unreliable access to care could have on vulnerable populations.

As a young woman Dr. Calamia traveled to the Philippines during summer vacations. There, she would assist her brother, a dentist, in small dental clinics in towns outside Manila. In the Philippines, where eight out of 10 people face dental health issues, millions of people have never seen a dentist due to absence of transportation and limited education. Without proper care, dental decay can lead to chronic disease, premature births, low birth weight, and more.

“As a young person growing up in the ‘70s, I remember thinking that sections of extreme poverty like those I had seen in the Philippines and also in Africa would no longer exist by the time I was in my 30s or 40s,” she says. “I thought we would solve those issues. Now, as the mother of a small child, I’m very passionate about addressing social determinants of health in the United States and abroad so that our children don’t have to find solutions to these problems in their 30s and 40s.”

Dr. Calamia, who joined Magellan Complete Care as chief medical officer in December 2019, sat down to discuss the role of healthcare organizations in addressing social determinants of health (SDOH)—the conditions in which people live, learn, work, and play that can affect health risks and outcomes—and ways that organizations can strengthen their approach.

Magellan: Could you tell us what sparked your passion for caring for vulnerable populations?

Dr. Calamia: My dad was a pilot for Pan American, and from an early age, my three siblings and I traveled internationally, including to Africa, the Philippines, and other countries. We became very cognizant of the impact that social determinants of health—from socio-economic factors to an individual’s physical environment—have on vulnerable populations, from the ability to access basic healthcare services to the ways in which barriers to basic necessities affect health and health outcomes. These experiences prompted each of my siblings and I to enter the medical field.

Early in my healthcare career I did work in Miami and was inspired to go into public health. I completed a fellowship in geriatrics, which enabled me to go into the homes of the seniors I was treating, which underscored for me the difference in health and health outcomes that can be achieved when individuals have reliable access to basic necessities as well as skilled care.

Magellan: What are some of the lessons you learned early in your career about ways to leverage federally funded programs to improve outcomes for the most vulnerable populations?

Dr. Calamia: When I was in private practice, my organization treated people who were on Medicare and Medicaid as well as those who were uninsured, but it was very difficult to support the care of these populations, financially. So, I got together with a group of providers on Staten Island [New York] to open a federally qualified health center (FQHC). This was a journey: It required us to form a community board to guide us through this process. I served as chief medical officer for the FQHC, and I worked with people who had been in the FQHC space for years and years. Through this experience, I learned how to be a good fiscal steward of the federal dollars we received by thinking about our programs strategically, with an eye toward which initiatives would make the biggest difference in members’ health. We concentrated on providing services for the most vulnerable mothers and infants in our community—for example, mothers who smoked or showed signs of substance use disorder; babies with low birth weights or whose first days or weeks were spent in the NICU. We were able to start the FQHC, and open two more centers. I’m really proud of that work.

Later, I joined a managed care company (MCO) and began to view social determinants of health initiatives from that organization’s point of view—which in some instances is a steward of both state and federal dollars.  Here, I began to look at the types of relationships that were necessary to ensure value. For example, how do MCOs find centers of excellence—the organizations that really move the needle on quality and value—to send their members? How do they make sure the programs these organizations provide meet the needs of their members and improve health outcomes?

As a result, we developed a partnership with Camden Coalition to determine how a very intense care management model could keep members out of the emergency department and keep them healthy. At that time, the managed care space incorporated more of a disease management model that wasn’t a face-to-face, in-home visit, hands-on model of care. After running a pilot program, we partnered with Camden Coalition to develop, test, and scale new models of care for members with complex health, behavioral, and social needs.

Magellan: What are some of the biggest challenges healthcare organizations face in addressing social determinants of health?

Dr. Calamia: I think we’ve been challenged as organizations to really measure the effectiveness of our interventions around the social determinants of health. We know that addressing social determinants of health is the right thing to do, and anecdotally, we have many stories about the ways in which addressing social determinants of health can change individual members’ lives. We need to aggregate, on a national level, the data we have and dig deep into the information we can glean from that—exploring where we can build relationships on a local level to change a few lives at a time and then using the lessons learned to scale our approach on a national level for specific populations.

Gaining access to this data may be a challenge for providers’ organizations as well because of limited resources and bandwidth. That’s why it’s so important that MCOs lean in and help them with the data piece—aggregating the data and providing the insight that can help providers dig deeper at the point of care.

When we think about social determinants of health, we have to look at the long game when it comes to understanding the results of our efforts. It’s also critical that we examine the potential for technology and digital apps, in combination with personalized care management, to help meet the needs of our most vulnerable populations in a holistic way. In doing so, we can more effectively help members live healthy, vibrant lives.

Magellan: How are SDOH coming into play during the COVID-19 pandemic?

Dr. Calamia: In so many ways. People are stuck in their homes. If they live in a crowded apartment building, it’s hard for them to distance themselves from others. Home may not be a safe place for victims of domestic violence. In certain urban areas, it’s already hard to get fresh food; with the pandemic limiting distribution, people are eating more processed foods. People who rely on home care services and home-delivered meals aren’t getting the services and sustenance they need. We’re seeing problems with meal distribution and have ordered restaurant take-out meals to ensure our members are fed. The health conditions many people have as a result of SDOH make them more likely to get very sick from the virus. That’s why it’s becoming more important than ever to address these issues.

 Magellan: What attracted you to Magellan?

Dr. Calamia: One of the biggest barriers I’ve seen in my career is helping patients and members determine where they are in their health journey and understanding their mental health needs. Magellan has a rich history of understanding mental health as a key social determinant of health. Frankly, the behavioral health community really understands social determinants of health. They have explored issues such as: Where do members live? Do they have food insecurities? Have they experienced childhood trauma that makes them more comfortable receiving care in an emergency department versus an office? Things of that nature. I believe there’s a chance to create something at Magellan that is really unique, leveraging Magellan’s behavioral health and pharmacy expertise as well as its depth of experience in working with MCOs to make a deep impact on social determinants of health.

We’re going to change the way in which people can access their healthcare, and we’re going to change the way that people feel about their MCO as a partner.

Edith Calamia, D.O., M.P.H., C.M.D., is national chief medical officer for Magellan Complete Care (MCC). Dr. Calamia joined Magellan in March 2020 and oversees all clinical programs within MCC. She also leads the development and delivery of health plan-specific clinical programs targeted to complex populations such as those needing Long-Term Services and Supports, those who are dually eligible for Medicaid and Medicare, people with Serious Mental Illness, and recipients of Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) benefits.

May is Mental Health Awareness Month. This is an opportunity to increase public awareness of mental health conditions.  We can break down the stigma by ending the silence. About 1 in 5 Americans experience mental illness. It is important to be able to talk openly about it to get people the help they need. It is particularly timely this year, as we are seeing stigma associated with COVID-19, and we must do what we can to stamp out stigma in all its forms.

Understanding mental illness

According to the National Alliance on Mental Illness (NAMI), a mental illness is a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis. If you have — or think you might have — a mental illness, the first thing you must know is that you are not alone. Mental health conditions are far more common than you think, mainly because people don’t like to, or are afraid to, talk about them.

Mental illness can affect anyone regardless of age, gender, income, social status, religion or race/ethnicity.

• 1 in 5 U.S. adults experience mental illness each year
• 1 in 25 U.S. adults experience serious mental illness each year
• 1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year
• 50% of all lifetime mental illness begins by age 14, and 75% by age 24

Depression and anxiety disorders are the most common mental health disorders worldwide.

The exact causes of mental illness are not fully understood. However, factors that can contribute to mental health problems include:

• Genes and family history
• Biological factors such as brain chemistry and brain injury
• Serious medical conditions
• The use of alcohol or other drugs
• Traumatic life experiences
• Isolation and other social factors

Mental illness is not a character flaw or something that a person can just “snap out of.” For many people, recovery — including meaningful roles in social life, school and work — is possible, especially when you start treatment early and play a strong role in your own recovery process.

Sadly, many people never seek treatment out of fear and shame. The stigma of having a mental illness or substance use disorder is two-fold: people suffer needlessly even though effective treatments are available, and they’re also at higher risk of premature death. For example, people with depression have a higher risk of heart disease and cancer. Studies also show that people with severe mental illness have a higher incidence of chronic diseases and tend to die 10 – 25 years earlier than the general population.¹

Stamping Out Stigma

Everyone experiences the ups and downs of mental health. Many people have a mental illness or know a friend or family member who has struggled with one. To stamp out stigma and get people the help they need NAMI offers these practical tips:

• Talk openly and honestly about your own experiences with mental illness and addiction.
• Educate yourself and others about the facts of mental illness. Mental disorders are treatable just as physical diseases are, and people with mental illness are not to blame for their condition.
• Recognize the signs of mental illness and seek professional help when needed.
• Show empathy for those living with mental health and substance use disorders.
• Be aware of your attitudes and language used to describe mental illness and people with mental illness. Jokes and name-calling are hurtful and perpetuate demeaning stereotypes.

Let’s work together to Stamp Out Stigma!

Sources:

[1] Management Information Sheet. (n.d.). Retrieved from https://www.who.int/mental_health

²Social Stigma associated with COVID-19. (2020, February). Retrieved April 10, 2020, from https://www.unicef.org/media/65931/file/Social%20stigma%20associated%20with%20the%20coronavirus%20disease%202019%20(COVID-19).pdf

COVID-19 has disrupted our lives in many ways. The stress of social distancing and loss of routine, compounded with health and job concerns, has caused grief and anxiety levels to increase. What we thought of as “normal” is in transition, and we need to redefine how to cope with these changes.

Reasons people feel grief

Grief is a natural feeling accompanying any kind of loss. Typically, grief is associated with losing a loved one to death. With COVID-19, people are experiencing grief related to the loss of routines, livelihoods and relationships. While it is always good advice to be thankful for what we have, it is also important not to minimize the pandemic or its associated losses. Also challenging is that we do not know how long we’ll be impacted by COVID-19. With no clear end in sight, feelings of grief can intensify and make people feel less in control.

Grief shows itself in different ways

It’s perfectly normal to grieve when you can’t celebrate your child’s birthday, your friend’s graduation, your honeymoon or other important life events. It’s important to know that we all grieve differently. Some people may experience feelings more intensely than other people. We shouldn’t make judgments about how someone grieves. There is nothing wrong with having emotions; it is a common response to loss. When we don’t express our feelings, they can get stuck in our bodies, causing physical illness and/or depression.

Listed below are some of the common emotions people experience when grieving, and they may be heightened because of the pandemic.

• Shock, disbelief and denial
• Anger
• Fear
• Guilt
• Helplessness
• Anxiety and depression
• Acceptance and hope
• Relief

Complicated grief

In the current environment, any losses experienced now have additional layers of complexity and depth. Likewise, if we’ve had previous traumas from earlier stages in our lives, the stress of the pandemic might bring up past life experiences that were painful. It’s important to be sensitive to those potential triggers.

COVID-19 has brought on many situations: not being able to say goodbye, to have a funeral service, to grieve because of taking care of others, dreams put on hold, etc. We don’t have the same levels of support due to the quarantine, such as being able to see loved ones and friends. For these reasons and others, it is important to develop coping skills to help get us through this difficult time.

Understanding grief

Part of what gives comfort during challenging times is understanding the healing process.

• Grief can be an ongoing process. It can take on different forms and meanings and with time; the intensity and feelings of grief do change.
• Grief doesn’t mean you obsessively think about what has happened. It is important to allow yourself to deal with the feelings, but obsessively thinking about the pain and fear will only make the feelings worse and can trigger anxiety.
• Grief does not mean “forgetting.” If you have experienced a significant loss or you have missed out on a long-planned event, it is okay to think about who or what you will miss. Part of the grieving process involves keeping your loved ones and/or cherished dreams with you emotionally, as they are still a part of you even if they are no longer a physical reality.
• Grief involves growth. Whether it is coping with the death of a loved one, going through a traumatic event or dealing with the loss of a job, no one chooses these experiences. Working through grief and sorting through intense emotions can help you learn new things about yourself and discover new strengths that can result in emotional growth and maturity. In this way, loss sometimes yields gifts.

How to help yourself

• Build a virtual support system. In the era of social distancing, be creative about how to give and receive support. It’s important to turn to friends, co-workers or family members for support. People like to be of service. Giving and receiving are part of the same equation and benefit all.
• Focus on hope. We all have times when we feel hopeless. Being hopeful helps you realize that we all have tough times and that those times will pass, as will the feelings associated with them.
• Take care of yourself. The mind and body are connected. When you feel good physically, you also feel better emotionally. When you feel sad, do not be influenced by how others think you should grieve. It’s important to feel whatever you feel without embarrassment or judgment. It’s okay to be angry, cry or not cry. It’s also okay to laugh, find moments of joy and let go when we’re ready.
• Practice gratitude. Sometimes when people are in the midst of loss, they have deep moments of gratitude for what they once had. Practicing gratitude trains our minds to change our thinking and to see the glass as half full.

How to help others

• What to say. It can feel awkward when conversing with someone going through grief. You may wonder what to say ornot say; however, don’t avoid the topic or be afraid to bring it up. Open the door for the grieving person to talk about their feelings. It’s not helpful to say things like, “There’s a reason for everything,” or ” “I know how you feel.” Instead, you can offer a simple expression of sorrow, such as “I’m sorry you’re going through this,” or “I don’t know how you feel, but I’d like to help in any way I can.”
• Sometimes the best thing to say is nothing. Or very little. A grieving person may need to tell their story again and again as part of the process. Be willing to listen without judgment. A good rule to follow is to listen 80 percent of the time and talk the other 20 percent. Your presence can be comforting to a grieving loved one, and you don’t have to do anything special. Often, grieving people just don’t want to be alone.
• Avoid giving advice. Unless someone specifically asks for your advice, it isn’t your place to give it. Grieving people need to do things in their own unique way.
• Don’t take things personally. When people are in profound emotional pain, they can cycle through a whole range of feelings, including irritability and anger. If a grieving person snaps at you, or doesn’t feel like engaging, don’t take it personally. It’s not about you.
• Offer to help. Grieving can make the demands of daily living feel overwhelming. Many times, the grieving person does not want to burden others by asking for help. Don’t wait for them to ask. Instead, offer to help by bringing over dinner, shopping, gardening, etc. During the quarantine, there might be a limit to what you can physically do to help, but you can still take on tasks for the individual to relieve some burdens.

For more information and tips, visit MagellanHealthcare.com/COVID-19.

As the pandemic grows, healthcare workers are experiencing a new level of stress and fear. Since our first piece about healthcare workers and mental health, the toll that COVID-19 cases have taken on them has become more difficult than any could have imagined.

First, let us again say thank you to all of you, from EMTs who answer the first calls to the doctors and nurses who tend to the sickest. Your selflessness and heroism is inspiring.

We’ve set up a counseling hotline for healthcare workers and first responders at 1-800-327-7451 (TTY 711). Your call will be answered by our licensed mental health clinicians. Our team is trained and ready to listen and help during this difficult time.

There are so many things that are out of our control. We are dependent on others to address many aspects of the big picture, but there are things outlined below that we can do for ourselves and those close to us. No single recommendation is enough by itself, but when taken together, they may help.

Talk about it

Acknowledge your anxiety, fear and grief, and talk about it.

Many of our colleagues and friends say that leaning on fellow healthcare workers is very difficult. Everyone’s heart beats a little bit faster when they greet a COVID-19-positive patient, so how can we ask them to support one another? Yet this is what we do as a medical community daily. Peer support is key.

• If a compassion fatigue group isn’t available at your workplace, work with your employer to put one together.
• If a group option isn’t available, talk to your co-workers about what you are seeing and how it is affecting you. You’ll be surprised at how many share your feelings but have been afraid to say anything. Hospital workers have talked about how a quick meeting at the beginning of their shift, during a break or at other times—to talk, pray, or have a moment of silence—has helped them tremendously.¹
• Many hospital systems have been deploying their psychiatric workforce as volunteers to help colleagues who need it.² Ask your employer if this is available.
• If you don’t want to talk about it at work, find a former co-worker or friend from school or training to talk to, or contact Magellan Healthcare at the phone number above.
• Finally, if you are at a point where your feelings impact your ability to perform or feel comfortable in your role, talk to your supervisor or your organization’s human resources group about your employee assistance programs. Monitor your physical and mental symptoms. You may reach a position that you need to be treated by a behavioral health professional. If that happens, contact one as soon as possible.

Make your voice heard

Some healthcare workers are feeling betrayed by their employers and others.² Whether it’s lack of PPE, feeling unappreciated or being expected to work excessive hours, these feelings can make an already untenable situation worse. While there is much you cannot control, don’t let that stop you from advocating for yourself and others.

• Ask for more PPE or the protocols for how it is allocated. Understanding why things are happening can help people accept them and enable you and your colleagues to offer suggestions from the front lines.
• If you are frustrated about things that you see, think about how you would make them better. Make a list and discuss them with coworkers to come up with solutions. Once things slow down, you’ll have strong suggestions for improving your work environment.

Maintain focus

• Remember why you became a healthcare worker. Maybe you watched a family member battle an illness, or you felt a calling to help people. Think about that during these times.
• Remind yourself that what you are doing is noble. The cognitive impact of recognizing the value you offer will help you serve your patients in a positive way.
• Consistent with your training and dedication, keep your focus on the patient in front of you, on protecting yourself to the best of your abilities and extending those protections to the home setting when you are off work.
• When you are off work, turn your focus to what is happening in the moment.

Take care of yourself

• We acknowledge that recommending meditation or focusing on breathing in the midst of chaos and fear may not seem helpful for some. Think about how you breathe when you are stressed. Some of us hold our breath without realizing it; others breathe very shallowly. We don’t realize it until we get around to taking a real breath.
• As you work around people with COVID-19, you might be afraid to breathe deeply. If you can, try to go to a place where you feel comfortable doing so, and take a few deep, slow breaths. Something as simple as this can release stress and clear your mind.
• Exercising may feel like a lofty goal as well. Try to find 10 minutes for a brisk walk, or a quick set of jumping jacks, sit-ups and push-ups.
• If you don’t have time or energy to cook, find easy-to-eat fresh foods like bananas, oranges and carrots.
• To help you relax and get to sleep, try apps like Headspace, Calm and Balance. AMA members can access these for free.
• Finally, if you are on medications for a pre-existing behavioral health condition, don’t stop taking them, and contact your provider if your symptoms are getting worse.

For more information and tips, visit www.MagellanHealthcare.com/COVID-19.